Provider Demographics
NPI:1881022895
Name:MELENDEZ, JENEAUREY (APRN)
Entity Type:Individual
Prefix:MS
First Name:JENEAUREY
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4645 AUGUSTA RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:SC
Practice Address - Zip Code:29842-7265
Practice Address - Country:US
Practice Address - Phone:803-380-7012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18550363LF0000X
FLAPRN9433010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily